Publications by authors named "John Stulak"
Objective: There are limited data on the outcome of routine cardiac operations in patients with cardiac amyloidosis. This study studied the impact of amyloidosis on early and late results of cardiac operations.
Methods: This was a retrospective, propensity-matched, case-control study of patients with cardiac amyloidosis undergoing cardiac surgery.
Objective: To study the effectiveness of virtual reality (VR) in reducing anxiety levels in patients undergoing first-time sternotomy for cardiac surgery.
Patients And Methods: A total of 100 adult patients scheduled for cardiac surgery at Mayo Clinic in Rochester, Minnesota, USA, was recruited from April 19, 2022, to October 12, 2022. Before surgery, patients wore a physiological monitor to record vital signs.
Article Synopsis
- - AEF is an uncommon but serious complication that can occur after PVI procedures.
- - The presence of free air in the left atrium or pericardium seen on chest CT helps confirm a diagnosis of AEF following PVI.
- - Standard treatment for AEF is urgent surgical repair, and potential complications can include strokes caused by emboli.
A comparative meta-analysis of addition of ganglionic plexus ablation versus no ganglionic plexus ablation to pulmonary vein isolation for atrial fibrillation.
J Interv Card Electrophysiol
November 2024
Objective: Females continue to be underrepresented in academia. An analysis of gender representation among presidents of cardiothoracic surgery societies worldwide was performed.
Methods: A comprehensive search was performed to identify cardiothoracic surgical societies present worldwide and divided by regions.
Article Synopsis
- Migration of a fragmented sternal wire is a rare complication after cardiovascular surgery, with clinical symptoms ranging from being asymptomatic to severe hemodynamic instability.* -
- A retrospective review revealed 13 cases of this issue, primarily affecting older men (median age 64), with nearly half experiencing hemorrhagic shock, and most cases presenting either shortly after surgery or years later.* -
- Identifying this complication often involves CT scans, but successful management requires careful attention to the patient's specific situation following diagnosis.*
Article Synopsis
- The study investigates how the timing of coronary artery bypass grafting (CABG) after an acute heart attack affects patient outcomes, focusing on both early and long-term mortality rates.
- Researchers analyzed data from 1,631 patients who had CABG, categorizing them based on whether surgery was performed within 24 hours, between 1 to 7 days, or more than 7 days post-heart attack.
- Results showed that while early mortality rates were similar across timing groups, those who had CABG more than 7 days after an attack faced significantly higher risks of late mortality, particularly in patients with non-ST-segment elevation myocardial infarction.
Objectives: To estimate gender disparities among first and last authorships in cardiothoracic randomized controlled trials (RCTs) and association of gender with publications in high-impact journals.
Methods: PubMed/MEDLINE database was searched from 1 January 2014 to 31 December 2020 using R statistical software via the 'easyPubMed' package to retrieve pertinent data. The 'gender' package was utilized to determine gender using the United States Social Security Administration Baby Name Data.
Article Synopsis
- The study analyzed over 148,000 coronary artery bypass grafting (CABG) cases to assess risks associated with clopidogrel (a blood thinner) taken within 5 days prior to surgery.
- It found that patients who had used clopidogrel had slightly higher operative mortality and significantly higher rates of mediastinal reexploration for bleeding and blood product use compared to those who hadn't taken the drug.
- The risks decreased the longer the wait after stopping clopidogrel, reaching similar outcomes for surgeries performed 3 days after the last dose compared to 5 days, suggesting 3 days may be a sufficient waiting period before CABG.
Cardiac fistulas present diagnostical and therapeutical challenges due to their variability in size, shape and pathway. Three-dimensional printing is increasingly used to provide a tactile representation that aids in preoperative planning and patient education. We present the case of a female in her 60s who developed a fistula between the left ventricle, right atrium and coronary sinus 2 years after bioprosthetic valve replacement.
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- - The study analyzed outcomes of intravascular ultrasound (IVUS) versus non-IVUS in patients undergoing peripheral vascular intervention (PVI) using data from the National Readmission database between 2016 and 2019.
- - It involved a large cohort (434,901 hospitalizations) and found no significant difference in major amputation rates at 6 months between both groups, with amputation rates being 2.17% for IVUS and 2.71% for non-IVUS.
- - However, in specific subgroups, namely patients with rest pain, those receiving iliac interventions, or those with drug-eluting stents, IVUS use was associated with significantly lower major amputation rates.
Article Synopsis
- - The study aimed to explore the occurrence of restricted cusp motion (RCM) during bioprosthetic tricuspid valve replacement (TVR) and its risk factors and effects on patient outcomes.
- - Out of 476 patients analyzed from 2012 to 2022, 31.5% exhibited RCM, with 13.2% having complete immobility and 18.3% showing limited movement of the valve cusp.
- - The research found that certain factors, like the type of valve used and patient-specific measurements, significantly influenced the likelihood of RCM, which was linked to a higher mortality risk, highlighting the importance of careful prosthesis selection.
Article Synopsis
- - The study compared the hemodynamic function of two mechanical aortic valve prostheses (On-X and Top Hat) using data from 512 patients who underwent valve replacement between 2011 and 2019.
- - Researchers matched 320 patients based on specific criteria and found that despite differences in valve sizes and implantation times, the overall functional outcomes (AV area index) were similar for both valve types at discharge and during follow-up.
- - The On-X group had longer aortic cross-clamp times than the Top Hat group, suggesting that the On-X valves might be more complex to implant despite having no significant difference in function.
Objective: Despite the development of dedicated, two-stent strategies, including the double kissing (DK) crush technique, the ideal technique for coronary artery bifurcation stenting has not been identified. We aimed to compare and determine the absolute risk difference (ARD) of the DK crush technique alone versus provisional stenting approaches for coronary bifurcation lesions, using the Bayesian technique.
Method: We queried PubMed/MEDLINE to identify randomized controlled trials (RCTs) that compared DK crush technique with provisional stenting for bifurcation lesions, published till January 2023.
Background: This study characterized the association of preoperative anemia and intraoperative red blood cell (RBC) transfusion on outcomes of elective coronary artery bypass grafting (CABG).
Methods: Data from 53,856 patients who underwent CABG included in The Society of Thoracic Surgeons (STS) Adult Cardiac Database in 2019 were used. The primary outcome was operative mortality.
Article Synopsis
- Traumatic Thoracic Aortic Injury (TTAI) is a severe condition with high mortality, being the second leading cause of death among trauma patients, and this study examined the trends in mortality from TTAI in the U.S. between 1999 and 2019.
- Utilizing CDC-WONDER data, researchers analyzed death certificates and demographic information using specific coding to better understand mortality rates related to TTAI, adjusting for factors like age, race, and gender.
- The study found a significant decrease in the age-adjusted mortality rate for TTAI, from 0.759 to 0.223 per 100,000 population, with reductions observed across various age groups, genders, races, and
Background: Left ventricular assist devices (LVAD) have an associated infection rate of 13%-80% postimplant. An optimal strategy for surgical infection prophylaxis (SIP) at the time of implantation has not been well defined. We aimed to evaluate the different LVAD implantation antibiotic prophylaxis regimens as well as the incidence of LVAD infection at our institution.
View Article and Find Full Text PDFRemoval of intracaval and intracardiac leiomyoma in a 49-year-old woman.
J Vasc Surg Cases Innov Tech
September 2023
Primary cardiac angiosarcomas (PCA) are highly aggressive malignant heart tumors. Previous reports have shown a poor prognosis regardless of management, and no consensus or guidelines exist. It is necessary to clarify this information since patients with PCA have a short survival.
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- The study aims to explore the link between long sleep duration and mortality from atrial fibrillation/atrial flutter (AF/AFL) due to mixed findings from previous research.
- Using data from the CDC and BRFSS, researchers categorized counties by the percentage of their population getting enough sleep (≥ 7 hours) and calculated age-adjusted mortality rates (AAMR) for each group.
- Results showed that higher AAMRs for AF/AFL were associated with long sleep duration, suggesting the need for more awareness and research on sleep's impact on heart health.*
Background: Severe tricuspid regurgitation (TR) is associated with considerable morbidity/mortality in an elderly population with multiple comorbidities. There is interest in transcatheter interventions to manage severe TR. Understanding complex right heart (RH) geometry and tricuspid valve shape and size has implications for patient/device selection for transcatheter intervention.
View Article and Find Full Text PDFThere is limited knowledge of pulmonary physiology and pulmonary function after continuous flow-left ventricular assist device (CF-LVAD) implantation. Therefore, this study investigated whether CF-LVAD influenced pulmonary circulation by assessing pulmonary capillary blood volume and alveolar-capillary conductance in addition to pulmonary function in patients with heart failure. Seventeen patients with severe heart failure who were scheduled for CF-LVAD implantation (HeartMate II, III, Abbott, Abbott Park, IL or Heart Ware, Medtronic, Minneapolis, MN) participated in the study.
View Article and Find Full Text PDFObjective: Concomitant coronary artery bypass grafting (CABG) and pericardiectomy (PC) can be a technically challenging operation. We sought to study the outcomes of patients undergoing concomitant PC and CABG.
Methods: Between July 1983 and August 2016, 70 patients (median age, 67 years; 88% males) underwent concomitant PC and CABG (PC + CABG group).